Individual
DR. JAMES NICHOLAS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 N 8TH AVE, SUITE 1A, DILLON, SC 29536-0000
(843) 774-2478
(843) 774-1826
Mailing address
705 N. 8TH AVE, SUITE 1A, DILLON, SC 29536-0000
(843) 774-2478
(843) 774-1826
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30917
SC
Other
Enumeration date
07/09/2008
Last updated
07/16/2012
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